Intelligent Design and Imaginary Worlds in Cost-Effectiveness Claims: An Overview of Commentaries in INNOVATIONS in Pharmacy from July 2016 to February 2017

Abstract

Abstract

The Imaginary Worlds of ISPOR: Modeled Cost-Effectiveness Claims Published in Value in Health from January 2016 to December 2016

“…As noted above, the common theme in the commentaries published in INNOVATIONS in Pharmacy since mid-2016 is that the recommended standards and their application in health technology assessments fail to meet the standards of normal science 4 . Rather than focusing on generating testable hypotheses to assess anticipated comparative product performance, the studies fall back on creating modeled imaginary worlds in which the comparative claims are immune to failure.…”

“…In previous commentaries it has been pointed out that if patients are non-persistent with therapy then if the majority of patients are non-compliance within two to three years of an index prescription 4 . It makes little sense to advocate formulary acceptance from a lifetime high-compliance cost-utility model.…”

Potentially Actionable Targets: Evidence Standards for Credible Next Generation Sequencing Technology Assessment Claims

“…Unfortunately, previous commentaries in this series have pointed out that health technology assessments over the past 30 years have shown a dogged commitment to building models to support cost-effectiveness and cost-utility claims that are unevaluable 12 . Particularly egregious are lifetime cost-per-QALY claims that clearly fail the standards of normal science.…”

Transparency, Imaginary Worlds and ICER Value Assessments

“…As part of this ongoing critique four ICER reports have been reviewed 2 3 4 5 Most recently, a comprehensive review has been presented detailing what are seen as the major methodological flows in the construction of ICER lifetime costper-QALY models, with recommendations for abandoning the ICER modeling approach in favor of short-term models that generate evaluable claims 6 . This latest review of the ICER methodology should be seen in the context of some 30 commentaries published in INNOVATIONS in Pharmacy since July 2016 7 The focus of these commentaries has been to point to the failure of HTAs to meet the standards of normal science 8 . This is not an exceptional standard as it has been in place since the scientific revolution of the 17 th century 9 .…”